[The clinical effect of recent decline in the gastric cancer mortality rate]

The clinical effect of the recent decline in the gastric cancer mortality rate in Niigata Prefecture was studied. The age-adjusted death rate for gastric cancer has been declining from average 60.5 per 1,000,000 population during 1958-1967 to 38.6 in 1981. From our analysis of surgically treated gastric cancer patients registered between 1972-1981 in Niigata Prefecture, the age-adjusted rate of early gastric cancer increased from 4.6 per 1,000,000 population in 1972 to 11.5 in 1981. Therefore, we conclude that there was a surgical effect of 46.1% in the decline in the gastric cancer mortality rate as of 1981.

[Delayed menarche following early onset of athletic sports training]

To investigate the effect of athletic sports training on the onset of menarche, we submitted questionnaires to college students at University of Tsukuba. 311 students (174 college athletes and 137 non-athlete control students (group C) completed the questionnaires. The college athletes were divided into hard physical activity (group A) and moderate physical activity (group B) groups. The average age was similar in each group. The physical profile showed that group A and B were significantly (p less than 0.001) taller and heavier than those of group C. There was no significant difference among the average menarcheal age of group A (12.9 +/- 1.1 years, Mean +/- S.D.), group B (12.8 +/- 1.1 years) and group C (12.6 +/- 1.0 years). However, some of athletes in group A who had begun sports training before menarche had a later menarcheal age (13.1 +/- 1.1 years, p less than 0.001), and others who had begun training after menarche had a significantly earlier menarcheal age (12.1 +/- 0.9 years, p less than 0.001) whereas in group B the average menarcheal ages of premenarche-trained (12.9 +/- 1.1 years) and postmenarcheal-trained (12.3 +/- 1.1 years) students were similar to that of group C. These data indicate that early beginning of hard athletic training delays the onset of menarche.

Seventeen year follow-up of a patient with hypertrophic cardiomyopathy which progressed to dilated cardiomyopathy

The progression of hypertrophic cardiomyopathy (HCM) to dilated cardiomyopathy (DCM) has been rarely reported. We report a patient with HCM who had been followed for 17 years and in whom DCM became evident.

Recurrent cervical cancer in the pelvis--intra-arterial infusion of oncostatics

Five cases of recurrent cervical carcinoma with sites of recurrence restricted to the pelvis were treated by intra-arterial infusion of oncostatics via the bilateral internal iliac arteries. One tip of the catheter was positioned in the internal iliac artery, proximal and close to the superior glutea artery, through the arteria glutea superior or inferior with ligations of both arteria glutea superior and inferior so as to give high concentration of drugs in the lesion. The other tip of the catheter was introduced subcutaneously up to the subclavian fossa of the anterior chest and was secured to the skin. Several chemotherapeutic agents (cisplatin, adriamycin, pepleomycin, mitomycin C and 5-fluorouracil) were infused repeatedly through the catheter, once or twice a week. The clinical efficacy according to Karnovsky's criteria was 0-C in one case, 1-A in one case and 1-B in three cases. The overall response rate of 1-B or higher was 60%. Two patients died, one from inflammation in the pelvic dead space and disseminated intravascular coagulopathy, the other from myocarditis and heart failure. The other three are alive and being treated by weekly intra-arterial infusion of chemotherapeutic agents at our outpatient clinic. No problems, such as spontaneous removal of the catheter, inflammation around the catheter or bleeding, have been encountered. The toxicity of the oncostatics in case of intra-arterial infusion was less pronounced than in the case of intra-venous administration of the same dose.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of phospholipase A2 and platelet aggregation by glycyrrhizin, an antiinflammation drug

We studied the effect of glycyrrhizin, a compound known as an anti-inflammatory and antiallergic drug, on the membrane permeability change induced by phospholipase A2 (PLA2) and on platelet aggregation. Glycyrrhizin was found to inhibit the PLA2-induced carboxyfluorescein (CF) release from D,L-dipalmitoyl phosphatidylcholine (DPPC) liposomes. Part of this inhibitory effect of glycyrrhizin on PLA2 is accounted for by the physical state of the substrate, the DPPC liposome membrane. Glycyrrhizin also inhibited collagen-induced platelet aggregation in a concentration dependent manner, which may in part account for its inhibitory effect on PLA2.

Seasonal variation of serum high density lipoprotein cholesterol levels in men

To determine if there are seasonal variations in serum high density lipoprotein cholesterol (HDL-C), the concentration of HDL-C was measured monthly for 12 consecutive months in 31 healthy men and 24 male inpatients with schizophrenia. In addition to HDL-C, total cholesterol (TC) and triglyceride (TG) concentrations in serum were assayed, and low density lipoprotein cholesterol (LDL-C) was estimated by calculation. Mean serum HDL-C levels of schizophrenic patients were significantly low compared with those of healthy controls, 35 +/- 12 and 49 +/- 11 mg/dl, respectively. The TC levels of schizophrenic patients were significantly higher in January and March as compared with August. The HDL-C levels in summer and autumn were significantly lower than those in winter and spring in both healthy men and schizophrenic patients. The concentration of LDL-C was significantly high in September and October as compared with April in healthy men. In patients with schizophrenia, LDL-C level seemed higher in January and March as compared with August.

[Current status and problems of gastric cancer in the aged]

Based on our analysis of 1) gastric cancer patients surgically treated between 1972-1980 in Niigata Prefecture, 2) mortality statistics, and 3) 381 gastric cancer patients older than 70 years operated in our hospital, we concluded that 1) The number of geriatric surgical patients with gastric cancer, especially early gastric cancer, is on the increase in Niigata Prefecture. 2) The mortality from gastric cancer has decreased markedly in 70-74 year-old patients, has declined slightly in patient ranging from 75-79 years and has increased in patients over 80 years. 3) In patients between 75-79 years and 70-74 years, surgery as almost equally safe and their long-term survival rate was similar. Our results suggest that gastric cancer patients ranging between 75-79 years should be operated as radically as younger patients.

[Intra-arterial infusion of oncostatics in recurrent cervical carcinoma]

Five cases of recurrent cervical carcinoma with restricted recurrent site in the pelvis were treated with intra-arterial infusion of oncostatics via the internal iliac artery. The tip of the catheter was put in the internal iliac artery, just proximal to the superior glutea artery, through the a. glutea inferior or superior with ligation of both the a. glutea superior and inferior so as to get a high concentration of drugs at the lesion. Several chemotherapeutic agents, such as Cisplatin, adriamycin, pepleomycin, mitomycin C and 5-FU, were infused through the other end of the catheter, which was fixed at the subclavian fossa of the anterior chest. The clinical efficacies according to Karnofsky's criteria were 0-C in one case, 1-A in 1 case and 1-B in 3 cases. The overall response rate above 1-B was 60%. Two cases were dead, one due to inflammation in the pelvic dead space and D.I.C. and other due to myocarditis and heart failure. The other three were alive and treated with weekly intra-arterial infusion at our outpatient clinic. No troubles, such as spontaneous removal of the catheter, inflammation around the catheter or bleeding, have been encountered. The toxicities in the case of intra-arterial infusion were less prominent than in the case of intravenous administration of the same dosage of the oncostatics.

Measurement of receptor-independent metabolism of low-density lipoprotein. An application of glycosylated low-density lipoprotein

Incubation of human low-density lipoprotein (LDL) with glucose results in a nonenzymatic formation of a Schiff base between the monosaccharide and lysyl residues of apolipoprotein B. Increasing the percentage of lysyl residues of apolipoprotein B modified by glycosylation decreases the fractional catabolic rate of the glycosylated LDL, and decreases the metabolism of the glycosylated LDL by human skin fibroblasts. The glycosylated LDL, containing 20-40% of total lysyl residues of apoprotein B modified, was metabolized at a slow rate by both human skin fibroblasts and mouse peritoneal macrophages. These results led to the suggestion that glycosylated LDL is primarily catabolized via a receptor-independent process. Assuming LDL catabolism occurs via receptor-dependent and receptor-independent processes, the ratio of (fractional catabolic rate of glycosylated LDL)/(fractional catabolic rate of native LDL) should be an estimate of the percentage of LDL catabolism via the receptor-independent process. From the fractional catabolic rates of glucose-LDL (20-40% of lysyl residues modified) and galactose-LDL (30-60% of lysyl residues modified) 41% and 30% respectively, of LDL catabolism occurred by a receptor-independent process.

[Study on distribution to oral tissues of long acting amoxicillin]

The distribution of L-AMPC, a newly developed long acting amoxicillin granules, was studied in oral tissues using New Zealand White rabbits. The antibiotic was dosed at 20 mg/kg and the tissue concentrations were measured in the tongue, gingiva, submaxillary gland, cervical lymph node and the parotid gland. Amoxicillin concentrations in liver and kidney were monitored for reference and urinary recovery was measured over 5 hours. All tissue concentrations were both high and persistent whereas amoxicillin concentrations in kidney and liver were high and low, respectively, the observation consistent with the published data for amoxicillin.

[Clinical studies of long acting amoxicillin in oral surgery]

Clinical studies with long acting amoxicillin (L-AMPC) have been carried out and the following results were obtained. 1. Forty-two patients with acute bacterial infections in the oral region were administrated orally L-AMPC at a daily dose of 1 gram. The clinical results obtained were classified as excellent in 3 cases, good in 28 cases, and the overall efficacy was 75.6%. 2. The antibacterial activity of AMPC was determined for 66 strains isolated from patients with oral infections. Of the strains tested, Gram positive cocci showed high sensitivity with MIC's less than 1.56 mcg/ml, while the sensitivity of PC resistance strains of S. aureus, K. pneumoniae and P. vulgaris was lower. 3. There was 1 case of transaminase elevation in the laboratory finding. 4. Five patients reported the following side effects, eruption 3, diarrhea 2, nausea 1, anorexia 1 and malaise 1. From the results of the present study, it is considered that L-AMPC is a useful antibiotic in the treatment of acute bacterial infections in oral region.

[Clinical experience with cefmetazole in the field of oral surgery]

Tissue concentrations of cefmetazole (CMZ) in rabbits were 17--49% of the blood levels at the corresponding time. Transfer pattern of CMZ was very similar to the pattern of the blood level, suggesting to be supposable the tissue concentration of CMZ. The clinical trial was studied concentrating on the observation of side effects and laboratory findings, especially the change of transaminase after anesthesia with GOF (gas-oxygen-fluothane). Four cases, who had anethesia with GOF, revealed the elevation of transaminase.

"Pseudo-cap" formation in Ehrlich ascites tumor cells induced by cytochalasin B

Cytochalasin B (CB) treatment induces or accelerates the capping phenomenon in some cells. In Ehrlich ascites tumor cells (EATC) CB treatment apparently induced the capping of Con A binding sites as observed under a fluorescent microscope. However, electron microscopic examinations revealed that the CB treatment did not induce a rearrangement of Con A binding sites, but rather it only induced a change in cell shape. On the contrary, CB treatment inhibited the capping phenomenon induced by treatment with Con A. Electron microscopic observations may give exact information on the distribution of lectin binding sites.

Glycosylation of LDL decreases its ability to interact with high-affinity receptors of human fibroblasts in vitro and decreases its clearance from rabbit plasma in vivo

Incubation of human LDL in vitro at 37 degrees C for 48 h with [14C]glucose at concentrations from 5 to 200 mM resulted in a glycosylated LDL, containing 0.4-20 mol of glucose incorporated per apolipoprotein B of 250 000 daltons. The extent of glucose incorporated was proportional to the time of incubation and concentration of glucose. Glycosylation of LDL abolished its uptake and degradation by the high-affinity process for LDL in normal human skin fibroblasts. 125I-labeled glycosylated LDL was bound, internalized and degraded by the fibroblasts via a nonspecific low-affinity process. The 125I-labeled glycosylated LDL and 125I-labeled LDL were taken up and degraded at similar rates in a non-saturable, low-affinity process by peritoneal macrophages isolated from mice. When 125I-labeled glycosylated LDL or 125I-labeled LDL were injected into rabbits, the glycosylated LDL had a delayed plasma clearance in comparison to the LDL. The mean fractional catabolic rates were 0.67 day-1 and 1.70 day-1 for 125I-labeled glycosylated LDL and 125I-labeled LDL, respectively. The uptake and degradation of 125I-labeled LDL by human skin fibroblasts was decreased as the concentration of free carbohydrate, glucose, sucrose or sorbitol, in the medium was increased from 10 mM to 1 M. It is speculated that pathologic levels of plasma glucose in vivo could result in a decrease in LDL uptake as a result of glycosylation of LDL. A decrease in uptake of native or modified LDL in vivo could contribute to hypercholesterolemia and its pathophysiology.